Acute Colonic Pseudo-Obstruction (Ogilvie's Syndrome) - A
Rare Complication in Total Abdominal Hysterectomy and Bilateral
Salpingo-Oophorectomy (TAHBSO)WithSigmoidectomy
Reviews of Progress, (March 2014)Abstract
Background: Acute colonic pseudo-obstruction(Ogilvie's Syndrome) as a syndrome
was first described by Ogilvie in 1948.'It is characterized by colonic dilatation in the
absence of mechanical obstruction or any obvious causes of paralytic ileus. The
condition can occur in patients with various metabolic, surgical, and medical problems.
It can also be idiopathic in a small percentage of patients.
Case Report: A 48 year old malay lady.Diagnosed with Ovarian Carcinoma proceeded
with TABHSO ,supracolicomentectomy and sigmoidectomy. Post operatively noted the
abdominal drain was 600 cc (serous) procede with CTabdomen TRO anastomosis leak
and the CT findings shows dilated large bowel with distal tapering and some narrowing
at the presumed anastomotic site at the rectum. Impression was Mechanical obstruction.
We proceeded with the Colonoscopy for decompression and to look for the anastomosis
site. Our diagnosis was pseudo-obstruction of colon (functional obstruction / Ileus) as
there is no evidence of mechanical obstruction and the whole colon was found distended.
Conclusion: We believe that Ogilvie's Syndrome, though uncommon, is a diagnosis to
consider when investigating patients who have recently undergone TAHBSO
withsigmoidectomy.Colonoscopy at the earliest possible time can be of both diagnostic
and therapeutic value as it provides